At a monthly meeting a few years back, the energy management team at Providence Healthcare in Scarborough noticed their water use had jumped by more than 50 per cent over the past few weeks. Their water usage data showed the hospital had mysteriously gone through millions of unaccounted for litres of water in less than a month—“lots and lots of swimming pools” worth of water, according to the facility’s director of environmental services Tom Clancey, that almost certainly indicated a pipe had burst. But there were no signs of flooding or water damage anywhere in the hospital. “Where is all that water going?” Clancey wondered.

The team began investigating and soon found a broken valve in the crawl space that was gushing water directly into a nearby drain. “Talk about pouring money down the drain,” Clancey said, sharing his story with a group of hospital managers in 2015. “Had we not been checking our usage levels, we wouldn’t have figured it out.”

Providence is a founding member of the Toronto and Region Conservation Authority’s Greening Health Care program. Launched in 2004, Greening Health Care helps hospitals work together to reduce greenhouse gas emissions through understanding their energy usage and the actions they can take to be more energy efficient. Over the past 13 years, 60 hospitals have signed on to the program, using the data analysis, best practices, and case studies provided by the program to improve their operations, replace equipment, and upgrade building systems—whatever their individual facilities need to make their energy performance the best it can be. To date, participants have cut their combined greenhouse gas emissions by 100,000 tonnes, and saved close to $28 million in the process.

Helping hospitals save energy may seem like a far cry from the TRCA’s original mandate of flood mitigation. But, according to Bernie McIntyre, it’s perfectly inline with the “living city” mission that has been pivotal in the organization’s approach to all its work since the early 2000s. “At that time TRCA was wrestling with the whole concept of sustainability,” says McIntyre, senior manager of corporate sustainability with the TRCA. “We did some real soul-searching and realized that sustainability is more than just environmental—it’s social, economic, and environmental.”

Indeed, McIntyre—and others tasked with developing the new living city vision—realized that focusing strictly on the environmental aspect of sustainability excluded people who simply weren’t swayed by the conservationist position. “Some people are very passionate about it,” says McIntyre. “But for others, if it doesn’t hit them socially or in the pocket book they are less engaged.”

The solution was a suite of programs focusing on saving energy in public and private buildings. The TRCA rolled out energy efficiency programs in schools, municipality and office buildings, as well as healthcare facilities with the goal of reducing emissions. The added bonus, of course, is large financial savings for participants that can then funnel those dollars back into their business or services. At the school level, McIntyre calculated that if every board in Ontario ranked in the 75th percentile for current energy efficiency among their peers, the province would save $71 million dollars and cut a quarter-million tonnes of greenhouse gases every year.

Trillium Health Partners Mississauga Hospital

To date, Greening Health Care has demonstrated that there is a lot of room for energy savings in the healthcare sector, which historically produces a large amount of waste. Data for all hospitals in Canada indicates that the sector is responsible for over a megatonne of average greenhouse gas emissions every year.

Part of the high consumption stems from old buildings built during a time when climate change was hardly a concern. Take operating rooms, for example: because hospitals are trying to avoid spreading infectious diseases, the air in operating rooms is constantly being changed, and cooled or heated in the process. That exchange process typically happens 24 hours a day, all year round, regardless of whether the rooms are being used. Understandably, this practice uses a lot of energy and costs the hospitals a lot of money. “So a few of our hospitals said, ‘Let’s work together to establish best practices for operating and controlling these systems,’” McIntyre explains. The resulting Greening Health Care research project engaged with industry experts to produce a best practices guide, instructing hospitals on how to safely pair back their air exchange systems. Many acute care member hospitals now follow the guidelines which have helped them cut energy use and costs by as much as 50 per cent.

McIntyre offers me the simple pitch he gives to hospital CEOs considering joining Greening Health Care, and which they relay back to their staff: “It saves money that you can put back into patient care,” he says. “If you can save $100,000 a year by reducing energy use, you can put that money right into patient care.” At a time when hospitals are coping with shrinking budgets amid rising costs, it’s a compelling argument.

“I’m also often pleasantly surprised by the importance hospital CEOs place on the relationship between energy, emissions and public health,” adds McIntyre. “Many regard environmental sustainability as central to the healthcare sector’s responsibilities.”

Certainly, operating and retrofitting buildings for better energy efficiency—while increasingly popular—isn’t a new concept. What makes Greening Health Care (and TRCA’s other programs) unique is the data-driven, evidence-based approach. Many attempts to reduce energy fall short because approaches are too theoretical, and savings are not verified. For example, a hospital may buy a new boiler that asserts to be more efficient, but if temperatures and pressures aren’t controlled appropriately, “you’re not going to realize the savings from the brand new equipment. In fact, in many cases you can save more energy and avoid large capital costs by operating your existing equipment more effectively.” McIntyre retorts.

According to to Enerlife Consulting, which provides technical direction for Greening Health Care, it happens surprisingly often that buildings fail to get the most out of their energy projects because they aren’t installed, operated or controlled properly, and nobody measures the actual savings after the upgrades are made. “The issue was they weren’t using the data to figure out how much they can save and where they can save it,” says McIntyre. Greening Health Care, by contrast, uses in-depth analysis of monthly and hourly electricity, gas, and water data over multiple years. When a new hospital joins the program, TRCA processes the data from their energy meters, compares it to other hospitals, and determines its savings potential relative to the 75th percentile of performance among its peers—a readily attainable target for most hospitals. Once they know how they stack up, the analysis points to specific areas where they can improve. Ongoing monitoring then tracks progress towards the target to verify the effectiveness of changes made, and identify new case studies to share with other member hospitals.

McIntyre recalls a major hospital that, until joining Greening Health Care, had been paying through the roof for electricity during the cooling season, which they had come to accept as normal. “We said to them, ‘You’re way off the curve—your bills shouldn’t be that high,’ and they insisted it was normal for their type of facility,” he says. “But we kept at them.” Eventually, they discovered that the cooling tower fans were running backwards and cooling efficiency was a fraction of what it should have been. “It cost very little to correct this deficiency, and their summer energy use went way down,” says McIntyre.

It’s not a stretch to assume that most people and organizations are keen to save money and energy, though many are at a loss for how to do that effectively. Greening Health Care has made that easy, and even hospitals outside Ontario are catching on. The program now has 13 participating facilities from Alberta, and representatives from a California hospital corporation flew in to join the group in their last workshop in June. “No one is doing the type of analysis or delivering the level of savings we’re doing here,” says McIntyre. “And the great news is we are applying these same principles to municipalities and schools. Members of our programs are recording millions of dollars in verified savings every year,” he adds. “And the quantified remaining savings potential is enormous.”